Permit CITY TIGARD
; MECHANICAL PERMIT
' ` - COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00599
T' . kRD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/8/2008
PARCEL: 1 S136DC -04500
SITE ADDRESS: 07501 SW DARTMOUTH ST 100 WINCO ZONING: C -G
SUBDIVISION: PP1995 -013 LOT: JURISDICTION: TIG
PROJECT: WINCO
Project Description: Installing (2) supply grills and (2) transfer return grills. Valuation: $750.00.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
WINCO FOODS LLC Description Date Amount
650 N ARMSTRONG PL
BOISE, ID 83704 [MECH] Permit Fee 12/8/200E $72.50
[TAX] 12% State Surch 12/8/200E $8.70
[MECPLN] Plan Rev 12/8/200E $18.13
Phone: 208- 377 -0110 Total $99.33
Contractor:
HVAC INC
5188 SE INTERNATIONAL WAY
MILWAUKIE, OR 97222 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 462 -4822
FAX 503- 462 -6555
Reg #: LIC 50897
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
•
41111111k '
Issued By: " 'ermittee Signature: /mac, 46,..,..,,,
...--,.‘ s
Call 503 5 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application , .. '` ¢�.` ` gh.mpo' � �7, ` .,` p
c* '( FOR OFFICE USE ONLY' �' k `'`
� l �.a„ 4 �.re . �; .sat. a ��,s ava � � �n a r� :r ru�
rkv City of Tigard �, Received �w
114 i Date/By: �! a, P ermtt N o. : c. >C9 ,� ("
C
a 13125 SW Hall Blvd., Tigard, OR 972 K�Q t� - � � Plan Re
Phone: 503.639.4171 Fax: 503.598.1' .I ■ 0� DateBy: ' ���� f r Other Permit: ft,„ T`(r(,�)7 i.
Inspection Line: 503.639.4175 a 10
T I G A R D O Y! Date Read By lur RI See Page 2 for
Internet: www.tigard or.gov O C G � Notified/Method: Supplemental Information
( l' f aS\°
TYPE OF .WO' . 1T , 1�G � COMMERCIAL FEE* SCHEDULE = USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction al Additi alterati c.;.; . acement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEG ONSTRUCTION .. Value: $ 7$O• ab
RESIDENTIAL EQUIPMENT / SYSTEMS FEES* '
❑ 1- and 2- family dwellin [I Commercial / dustrial ❑ Accessory building
❑ Multi- family Master builder ❑ Other: For special information use checklist.
Description Qty. I Ea. 1 Total
JOB SITE.INFORMATION AND LOCATION . , Heating/cooling
SW ` �j�. n (�` Air conditioning or heat pump
Job site address:
7500 SLL) ,.1//•t42TMa,IT14 r (requires site plan showing placement) 14.00
City /State /ZIP: I I G 1 � 0p40
� Fumace 100,000 BTU (ducts /vents) 14.00
'l �^� All
Fumace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: (N �/1✓1 CO * - JC P/t -rt p Kf11 Gas heat pump 14.00
Cross street/directions to job site: 11 Duct work ' 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Flue /vent for any of above 6.80
Subdivision: Lot no.: Other: 1 10.00 w
Tax map /parcel no.: Other fuel appliances
. . DESCRIPTION. OF WORK Water heater 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
�" �(� �� � ` r I �f �(
v►151�(Lt'X t� �[1 �f es `WQ.!'f,1Ti1� /� /G4f'►'1 Log ligh g 10.00
I- Lo lighter ( as) 10.00
I` 1 t-t/3• Wood/pellet stove 10.00
Wood fireplace /insert 10.00
- ❑ PROPERTY OWNER I TENANT Chimney /liner /flue /vent 10.00
Other: 10.00
Name: 1 II I f AN e 4.2,3 Environmental exhaust and ventilation
Address: �/�J Range hood/other kitchen
equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
kJ- APPLICANT , Ig- CONTACT. PERSON Attic /crawlspace fans 10.00
�I 1 .I r Other: 10.00
Business name: I`'f A ` c piping
Fuel i
P g
Contact name: l iAAt P $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail:
Range
• CONTRACTOR - Barbecue
I , M to Clothes dryer (gas)
Business name: H {//,�
Other:
Address: 51 g-Q' ,E 4.4 P a MECHANICAL PERMIT FEES* -,
City /State /ZIP: c Ilk � iL kE f Subtotal
/' Minimum permit fee ($72.50) 7th .5l)
Phone: (5 ) �(Da _ 4 x'1 Fax: ( ) ( A a... 055 5 Plan review (25% of permit fee) ` ijt 13
CCB lic.: 50(R-1 State surcharge (12% of permit fee) B, 7 a
TOTAL PERMIT FEE
Authorized signature: go6 This permit application expires if a permit is not obtained within 180
(�� days after it has been accepted as complete.
Print name: Sift gift P t7 k LAAs on Date: _J a J Ri * Fee methodology set by Tri- County Building Industry Service Board
\
I:\BuildingWermitsMEC- PermitApp.doc 01/19 /07 440.4617T(11I /002/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information •
Commercial Fee Schedule:
Total Valuation: `Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00, or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
•
Note: All new commercial buildings require 2 sets of plans.
1:\ Building \Permits\MEC- PermitApp.doc 01/19/07 2
•
W.hco.2 ,Tob 40 ?tp , A
n stk.1 bAlaxm TH RRI.
U1 e..40,r
75oo
l 0
Sire,
C
,
N P, tea 1 Srer i5 ' ; ; e Ir .
� � fly 3t1 N . CO Q
N \ L ,
N -,, o — Check5 av 5
L- _ ( RECEIVED
is
DEC 0 8 2006
CITY OF TIGARD I'v p, (. I I C S
BUILDING DNISION
.4 - - Flu e , -COY 0 rc lIe
1230 2 1Wec,b ue,-4- ,
�'1 OF ,
Approved .N......,. s .a.. t
C� �� ( Conditionally Approved.‘,...:.....'... [ 1 I
See Letter toe Follow°. .,., ., [
-4-e,,; l --->
PermitN i , i :: L /o, - 0 ----.• •
XvINIA , . ` - � :� - ' ,e`er # / ,T tit . —L---4/AV (,, t .
V'' sµ1 P i l 1 1
OFFICE COPY'
CITY OF TIGARD
BUILDING DIVISION PERMIT #: M C "2000f1;59c;
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: °l;1/f3l7(li)13
Phone: (503) 639 -4171 ' 1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/1E&E2000 TIME: 7 :00AM PAGE:
SITE ADDRESS: 07601 SW DARTMOUTH ST 100 'WING° CLASS OF WORK:
SUBDIVISION: ppigc5.013 LOT #: TYPE OF USE:
PROJECT NAME: VVINCO
DESCRIPTION: Installing (2) supply grills and (2) transfer return grips. Valuation: $750.00.
OWNER: WINCO FOODS LLC, PHONE #: 200 377 - 0110
CONTRACTOR: HVAC INC PHONE #: ,503,16, - d 0 j 3
Inspection Request Scheduled For: Date: 12/1 2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 079072 -01 5034162 -4822 Y
Corrections /Comments /Instructions: Telfra 6( ei
A / /S
_ 7■ _
r
PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIO . AL E�
� Date: Phone #: (503) 8 +
Inspector: ( ) 71